Let's face it. It is undeniable that technology plays an increasingly important role in the delivery of patient care today. The important question is: What is the true value of technology? Has it made our jobs more difficult, or simplified or automated routine tasks? Are we more or less efficient? Has technology enhanced or atrophied our clinical assessment and diagnostic skills? In the end, has technology improved or diminished patient outcomes? In light of the shortage of nurses, does technology tend to decrease or increase the demand for skilled bedside caregivers?

For anyone who has much of a history at the bedside, we all can remember some wins and losses. I remember the first "portable nursing unit terminal" (circa 1983 or so), which its creators fondly referred to as the P-NUT. Nurses were supposed to carry it around to do vital signs and other simple diagnostic tests. As you would guess, it never caught on, mostly because there weren't too many nurses who had a hand free to carry it and keep it from getting lost in the linen!

I remember when the first blood glucose monitoring devices came out. What an improvement that made in the disease management and self-care of diabetics. Another technological success was the patient-controlled analgesic pumps, permitting patients to finally have a role in their own pain management. Think back about how technology has altered the care of your patients. Overall, has it been for the better? Let's hope so.

If one looks at the millions of dollars that health care organizations invest in technology annually, it is understandable that expectations are deservedly high. Through the experience of many successes and failures, I have learned that even the best technology can fail miserably if one essential ingredient is missed in either the development or implementation phase of a product. That critical ingredient is the practical and real-life knowledge and experience of bedside nurses and other intended users of the application. Without that, almost any technology will fail to demonstrate its value in patient care.

Successful technology is crafted for the user from its inception and requires an extensive understanding of the work to be accomplished, as well as the environment and other work processes that coexist around the work. It also requires field testing outside the lab with real-world caregivers and patients. Most importantly, when technology investments are made, the caregiver's choice should take priority over the low bid. You remember the old saying: You get what you pay for.

Successful integration of new technology also requires adequate time and resources for education and competency validation. Product, equipment and technology change-overs should never be a surprise to the caregivers at the bedside. Practice environments require designated clinical expert resources to ensure that technology use is based on a strong clinical foundation.

It also is important to appreciate that the value of technology does not rest in its revenue generation potential alone. Technology that improves workplace safety, efficiency of caregivers and the access to information should be just as important to health care organizations. For example, how can anyone ethically question the value of improved needle safety?

For the future, there is great optimism that new patient care technologies will increasingly contribute positively to the practice of nursing. However, these products and services will be developed successfully only with the wise counsel and advice of nurses. Offer your clinical expertise and consultative services to a company that has a product you use. In fact, why don't you and your co-workers offer yourselves as a learning lab for improving patient care technology? After all, you are both the expert and the ultimate customer.